On November 15, 2023, the Centers for Medicare & Medicaid Services released its proposed 2025 Notice of Benefit and Payment Parameters, the annual regulation which governs core provisions of the Affordable Care Act. This expert perspective focuses on aspects of the proposed rule likely to be of interest to state officials, including requirements for State-Based Marketplaces to align with the standards of the Federally Facilitated Marketplace, proposals for states to update essential health benefits, and initiatives to ease the eligibility and enrollment process for consumers.
State Reinsurance Programs: Design, Funding, and 1332 Waiver Considerations for States
Joel Ario and Jessica Nysenbaum, Manatt Health
Faced with a fluid federal regulatory environment, many states continue to encounter challenges in stabilizing their individual health insurance markets, including large premium increases and declining insurer participation. One solution to continued market instability is a state-based reinsurance program similar to the federal program that reduced premiums by more than 10 percent per year from 2014 to 2016. The brief provides a roadmap of policy, program design, and financing considerations for states that are contemplating development of a state-based reinsurance program under 1332 waiver authority.
The State Health Policy Highlight, State Reinsurance Programs and 1332 Waivers: Considerations for States, provides an overview of approved 1332 reinsurance waivers to date and spotlights a new 1332 application template developed by State Health and Value Strategies.